Cumulative updates imply Windows is slowly growing larger over time. If you perform a DISM ResetBase cleanup, then the oldest versions of any superseded (replaced) component will be removed. The drawback is you cannot uninstall the last update, which is fine if you're doing a clean install since you can always replace a bad install image.
In reality, because Monthly Updates are cumulative most of the packaged components are the same from month to month. So overlaying a newer update, where most of the internal components are already duplicated, won't grow the image that much from the previous one. Only newer components cause the real growth.
Replacing a component with the same version again doesn't make Windows bigger.
What is wasteful is keeping the earlier update versions around, and adding them to the processing queue.